Herpes zoster ophthalmicus-related oculomotor palsy in a pediatric patient

Rajput, Vimal Krishna; Aroor, Chaithra D; Kumar, Anupama Kiran; Bhandary, Prathana

doi:10.4103/jcor.jcor_20_19

Cited by 1 publication

(3 citation statements)

References 2 publications

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“…The initial presentation included subconjunctival hemorrhage in two cases [ 38 , 39 ]. Corneal sensation was noted in many studies to be decreased in the acute phase [ 12 , 21 , 25 , 40 – 46 , 53 , 54 ]. Other findings included anterior uveitis, iritis, and anterior scleritis.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Prognosis for recovery is good [ 60 ]. At least five cases of cranial nerve palsies associated with HZO have been reported in children [ 40 , 41 , 46 , 56 , 61 ]. The onset of symptoms, including binocular diplopia and ptosis, ranged from zero to 4 weeks following the initial onset of the HZO.…”

Section: Complicationsmentioning

confidence: 99%

“…Topical steroids were also given for stromal keratitis, and one patient was unable to be completely tapered from therapy due to reactivation [ 22 , 70 ]. Patients with cranial nerve palsies and encephalitis were treated with systemic steroids and demonstrated good recovery [ 40 , 41 , 52 ].…”

Section: Treatment and Outcomesmentioning

confidence: 99%

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Pediatric herpes zoster ophthalmicus: a systematic review

Hakim

Riaz

Farooq

2023

Graefes Arch Clin Exp Ophthalmol

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Purpose While typically affecting older adults and immunocompromised individuals, herpes zoster ophthalmicus (HZO) has been reported with varying manifestations and complications in children. In this review, we evaluate reported cases of pediatric HZO in the literature and discuss the epidemiology, risk factors, clinical presentation, treatment and outcomes. Methods A literature search on PubMed, Scopus, and Web of Science databases was performed using the terms “pediatric herpes zoster ophthalmicus” and “herpes zoster ophthalmicus children.” Publications that were not specific to HZO or pediatric populations were excluded, as were publications that were not available to review or not published in the English language. Results Fifty-seven reports describing 130 cases of HZO or HZO-related complications were reviewed. Major risk factors for pediatric HZO included intrauterine exposure to varicella or primary varicella infection at a young age; HZO also occurred in patients who had received varicella vaccination. Both healthy and immunocompromised children were affected, with the majority of affected children being immunocompetent. The diagnosis of HZO is primarily clinical. Children appear to have good vision recovery and resolution of symptoms if they are treated promptly and if they adhere to treatment regimens, except for irreversible vision loss related to uncommon complications such as optic neuritis. Conclusion HZO occurs in both healthy and immunocompromised children. Recognizing this treatable condition is essential for reducing ocular and systemic morbidity. Long-term follow-up and assessments of the impact on health in adulthood are lacking. More systematic study is needed to determine the incidence of HZO in children and appropriate diagnostic and treatment protocols for the care of pediatric patients with HZO.

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